Congenital Syphilis : Still a Reality in Bangladesh

Dhananjoy Das, Wahida Akter, Mohammad Ohi Uddin, R. Ahmed, M. Arzu
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Abstract

Congenital syphilis is caused by Treponema Pallidum. The fetus can acquire it transplacentally during maternal spirochetemia, or contact with genital lesion during the intrapartum period. The prevention and treatment of congenital syphilis are very much cost-effective, but if it remains undiagnosed and untreated, can result in a deadly outcome. It can affect multiple organs and systems. In this present case, skeletal systems were predominantly involved. The clinical presentation was the failure to gain weight, painful mobilization of the right arm, and swelling of the proximal and distal end of this arm. Erythematous, maculopapular scaly skin eruption was also noticed in the scalp and scrotum. Radiological examination showed metaphyseal irregularity, and periosteal reaction at the right humerus, radius, and ulna. Nontreponemal antibody test (VDRL) and a treponemal antibody test (TPHA) both were reactive. Early congenital syphilis may have a subtle clinical presentation or may remain asymptomatic. Therefore physicians should aware of the clinical presentation of congenital syphilis; at the same time, detailed clinical history can play an important role to suspect congenital syphilis. Promotion of pregnant women for antenatal care and screening for syphilis in the first trimester are the keys to eliminating congenital syphilis. Chatt Maa Shi Hosp Med Coll J; Vol.21 (1); January 2022; Page 73-77
先天性梅毒:在孟加拉国仍然存在
先天性梅毒是由梅毒螺旋体引起的。胎儿可在母体螺旋体病期间经胎盘感染,或在分娩期间与生殖器病变接触。预防和治疗先天性梅毒的成本效益非常高,但如果未得到诊断和治疗,可能会导致致命的后果。它可以影响多个器官和系统。在本病例中,骨骼系统主要受累。临床表现为体重增加失败,右臂活动疼痛,右臂近端和远端肿胀。头皮及阴囊可见红斑、斑疹状、鳞状皮肤疹。放射学检查显示干骺端不规则,右肱骨、桡骨和尺骨有骨膜反应。非螺旋体抗体试验(VDRL)和螺旋体抗体试验(TPHA)均有反应。早期先天性梅毒可能有一个微妙的临床表现或可能保持无症状。因此,医生应了解先天性梅毒的临床表现;同时,详细的临床病史对怀疑先天性梅毒有重要作用。促进孕妇产前保健和妊娠早期梅毒筛查是消除先天性梅毒的关键。上海医科大学医学院;月(1);2022年1月;页73 - 77
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